Front-Line Training Consultancy Limited

Enrolment Form

416  Dee  Street, PO  Box 748, Invercargill  |  Phone 03 214 2174  |  Email [email protected]

www.front-line.co.nz

Front-Line Training Consultancy Limited INSTRUCTIONS The purpose of this enrolment form is to get from you the information we need to enrol you into a qualification at our Institute. We also need to collect information from you which is required by the Ministry of Education, Tertiary Education Commission and other Government agencies for statistical, registration and monitoring reasons. Please fill in the form properly by: • Completing all sections of the form. • Printing your answers clearly in pen, or ticking the box that applies for multi-choice questions. • Signing the form. • Attaching to the form additional documentation that is required (see checklist)

COURSE INFORMATION Programme Name:

Office Use

Programme Start Date:

  Programme End Date (if known):

Have you enrolled at Front-Line before?  Yes

 No

   Do you intend to study:  Full time

  Part time

PERSONAL INFORMATION Surname:

Home Address:

Given Name(s):



Prefered First Name:



Previous/Maiden Name(s):

Phone:

Title:  Ms

 Miss

 Mrs

Date of Birth: 

 

Gender:  Male

 Female

 Mr

 Other



 

Mobile: Email: Postal Address (if different from above):

If you have an NZQA/National Student Number, please write



it here:



Are you an International Student?  Yes

  Post Code:

 No

Next of Kin: Relationship:

CITIZENSHIP

 Phone:

– Tick the square that best describes your citizenship or permanent residence status

New Zealand Citizen:

NZL

New Zealand Permanent Resident:

NZP

If “Other” please specify your Country of Citizenship. (For students with dual citizenship, specify the country of citizenship of the passport used to enter New Zealand)

Australian Citizen/Permanent Resident:

AUS

Country of Citizenship:

Other:

ETHNICITY

– What ethnic group do you belong to? You may tick up to 3 boxes

European/Pakeha or NZ European:

111

Samoan:

311

Other Pacific Island:

371

NZ Maori*:

211

Cook Island Maori:

321

Chinese

421

If you identified yourself as NZ Maori, what is the name of your iwi? You may enter more than one iwi. If you don’t know please write “don’t know”.

Tongan:

331

Indian:

431

Niuean:

341

Other Asian:

444

Iwi:

Tokelauen:

357

Other 89:



Fijian:

361



*

416  Dee  Street, PO  Box 748, Invercargill  |  Phone 03 214 2174  |  Email [email protected]

Page 1

www.front-line.co.nz

Front-Line Training Consultancy Limited ACADEMIC INFORMATION

PRIOR ACTIVITY

What was the name of the last secondary school you attended? State “overseas”, if applicable.

What was your MAIN activity or occupation in New Zealand as at 1 October last year? You may only tick one box.



Secondary student

What was your last year of secondary school? 

Non-employed or beneficiary

What is the highest level of achievement you hold from a secondary school? Your highest achievement may be a “traditional” award such as School Certificate, or you may have achieved a number of credits or a National Certificate at a certain level on the National Qualifications Framework. Your NZQA Record of Achievement shows you how many credits you have. Tick only one box.

Wage or salary worker

03

Self-employed

04

University student

05

Polytechnic student/Institute of Technology

06

House-person or retired

07

Overseas

08

01 (excluding retired)

02

No formal secondary qualifications

00

14 or more credits at any level

11

NCEA Level 1 or School Certificate

12

NCEA Level 2 or 6th Form Certificate

13

University Entrance

14

NCEA Level 3 or Bursary or Scholarship

15

Overseas qualification

09

Do you live with the effects of a significant injury, long term illness, disability or learning disability? The information you supply is confidential.

Other*

98

Yes

Not known

99

If yes, how would you describe your impairment, disability, learning disability or long term medical condition:

(includes International Baccalaureate & Cambridge Exams)*

*

Please specify if “Overseas qualification” or “Other”.

Private training establishment

09

Wãnanga student

10

DISABILITY

 No



Will this be the first year you have ever enrolled in a University, Polytechnic, Institute of Technology, College of Education, Private Training Establishment, or Wãnanga either in New Zealand or overseas since leaving school? Do not include enrolments in STAR, community or hobby classes. Yes

(irrespective of occupation)



LITERACY & NUMERACY

 No

– TEC or MSD funded programmes only

If you answered “No”, please enter the name of the institution you studied at and year of your first enrolment: Name:

 Year: 

What year do you expect to complete the academic requirements necessary to graduate from your qualification? Year: 

EMPLOYMENT

Providers are now required to use a Literacy and Numeracy Evaluation from the Adults Literacy and Numeracy website. Data collected from the learner assessments is personal information as defined by the Privacy Act 1993. The TEC will use data from the tool to inform it’s oversight and monitoring. Participant’s data will be used for this purpose only. The identity of individuals – learners and educators – will never be disclosed to the TEC as the data made available to the TEC will not be able to be traced back to individual names. This data is created to help measure organisational performance and for reporting to funders.

Have you ever worked in employment? Please tick one.

Have you completed a literacy/numeracy evaluation in the past?

Full time

Yes

  Part time

  Never

 No

How long was the employment? Over 12 months

  Less than 12 months

416  Dee  Street, PO  Box 748, Invercargill  |  Phone 03 214 2174  |  Email [email protected]

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www.front-line.co.nz

Front-Line Training Consultancy Limited DOCUMENTATION To qualify as a domestic student, and so be entitled to the Government tuition subsidy, you must be a citizen of New Zealand (this includes students from the Cook Islands, Tokelau, or Niue who have New Zealand citizenship), or a permanent resident of New Zealand, or a citizen or permanent resident of Australia residing in New Zealand. To provide evidence of citizenship or permanent residency you must produce one of the following: • Birth certificate with place of birth stated as New Zealand, Cook Islands, Tokelau, or Niue. • New Zealand passport. • A statement of Whakapapa, including date of birth, counter signed by a Kaumatua. • Certificate of citizenship or letter of confirmation. • Overseas passport with residency stamp. You can bring the original documentation to the enrolment desk, or alternatively provide a certified copy. This means a photocopy of your original document, signed as being a true and accurate copy by a Justice of the Peace (JP), Barrister or Solicitor, Notary Public, Court Register or Deputy Registrar, Member of Parliament, Land Transport New Zealand, Public Trust, or local authority employee designated for this purpose. When a learner is in a remote community and unable to access a person listed in the Oaths and Declarations Act, a member of the New Zealand Police, school principal, minister of religion, or general practitioner is acceptable. International students must bring their passport with them when they enrol. Please note that your name, date of birth and residency as entered on this enrolment form will be included in the National Student Index, if not already registered, and will be used in an Authorised Information Matching programme with the New Zealand Birth Register. For further information please see: http://nsi.education.govt.nz.

TERMS OF INVOICE

– fee paying students only

Terms of Trade Conditions All invoices are payable within 14 days of the date of issue unless by prior arrangement and agreement with the Managing Director. Return Cheques Any incorrect cheques are returned immediately. Refunded Deposits Deposit refunds are made within 10 working days (fees over $500 paid in advance are held in a student Fee Protection Fund – a Public Trust Account) Unpaid Invoices and Debt Collection All unpaid invoices are sent a reminder notice on the basis of their terms of agreement i.e. 14 days or a monthly account. Invoices that remain unpaid are sent a final notice based on Front-Line’s Terms and Conditions. Referral to a Debt Collection Agency follows on the same basis. Debt Collection Fees The cost of recovering debt will be added to the outstanding account. 20% per annum calculated on a monthly basis.

416  Dee  Street, PO  Box 748, Invercargill  |  Phone 03 214 2174  |  Email [email protected]

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www.front-line.co.nz

Front-Line Training Consultancy Limited DECLARATION/CONDITIONS Privacy – Front-Line collects and stores information from this form to: • Manage the business of the Institute (including internal reporting, administrative processes and selection of scholarship and prize winners). • Comply with the requirements of the Education Act 1989 and other legislation relating to maintenance of records and accountability for public funding. • Supply information to government agencies and other organisations as set out below. In signing this enrolment form you authorise such disclosure on the understanding that the Institute will observe the conditions governing the release of information, as set out in the Privacy Act 1993, the Education Act 1989 and other relevant legislation. You may see any information held about you and amend any errors in that information. To do so, contact the Enrolments Officer. NB: The Privacy Act came into force on 1 July 1993 with the stated aim of protecting the privacy of natural persons. It requires the Institute to collect, hold, handle, use and disclose personal information in accordance with the twelve information privacy principles in the Act which can be viewed on the Privacy Commissioner’s web site: http://www.privacy.org.nz/. Supply of Information to Government Agencies and Other Organisations The Institute supplies data collected on this form to government agencies, including: • The Ministry of Education. • The New Zealand Qualifications Authority. • The Tertiary Education Commission. • The Ministry of Social Development (in relation to student loans and allowances) and Inland Revenue (student loans). • Immigration New Zealand and the Ministry of Business, Innovation and Employment (for those who are not New Zealand citizens or permanent residents). • Agencies who support particular students through scholarships, payment of fees or other awards (if you are a recipient of one of these awards). Those agencies use the data collected from tertiary education organisations to: • Administer the tertiary education system, including allocating funding. • Develop policy advice for government. • Conduct statistical analysis and research. Your personal details (name, date of birth and residency) as entered on this form will be included in the National Student Index, if not already registered, and may be used in an authorised information matching programme with the New Zealand Birth Register. The government agencies above may supply data collected on this form to Statistics New Zealand for the purposes of integrating data with data collected by other government agencies, subject to the provisions of the Statistics Act 1975. Integrated data is used for the production of official statistics, to inform policy advice to government and for research purposes. In handling data supplied by you on this form, the government agencies are required to comply with the provisions of the Privacy Act 1993. When required by law, the Institute releases information to government agencies such as the New Zealand Police, Department of Justice, Ministry of Social Development, and the Accident Compensation Corporation (ACC). Information collected on this form may be supplied to other educational organisations for the purpose of verifying academic records. Fees – In signing this enrolment form you undertake to pay all fees as they become due, and to meet any late fees and collection charges associated with debt recovery. The Institute’s policy on withdrawal and refund of fees may be obtained from Reception. Rules – In signing this enrolment form you undertake to comply with the published rules and policies of Front-Line’s Terms and Conditions with regard to attendance, academic integrity and progress, conduct and use of information systems. Identity – If you have supplied a National Student number on this enrolment form, and your National Student Index status is verified, you are deemed to have declared that you are the legitimate owner of the claimed identity.

416  Dee  Street, PO  Box 748, Invercargill  |  Phone 03 214 2174  |  Email [email protected]

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www.front-line.co.nz

Front-Line Training Consultancy Limited CHECKLIST

HOW DID YOU HEAR ABOUT FRONT-LINE?

Have you...

Work and Income

Completed all the sections of this form?

Newspaper

Attached verification documentation? E.g. Passport, Drivers License, Birth Certificate.

Radio Word of mouth

Read, signed and dated the declaration?

Career expo Website Career advisor/teacher Support Agencies Please specify Other Please specify

DECLARATION Declaration – I declare that to the best of my knowledge all the information supplied on, and with, this enrolment form is true and complete. I agree to abide by the conditions described on page 4, and I consent to the disclosure of personal information as described on the declaration page of this form.



         /     /     

Signature Date

Office Use Only

Documentation

Approved

Entered







     /     /     

     /     /    

     /     /    

416  Dee  Street, PO  Box 748, Invercargill  |  Phone 03 214 2174  |  Email [email protected]

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www.front-line.co.nz